Patients That Opt for a Transplant That Still Shows Hairline Recession?
Hey doc, I noticed your blog here presents us with numerous demonstrations of surgeries, where a receding hair line is being restored to a full-blown NW1. However, the impact of surgery on donor area (whether FUT or FUE) has drawn me to weigh the benefits of smaller improvements.
But I don’t remember seeing here any pictures of patients who could easily (graft-wise) afford a Norwood 1 transformation, but have chosen a minimalistic path (for example, going from a Norwood 3 to a 2 or simply increasing the width of the forelock a bit to eliminate the steepness of its shape). Such visual representations will surely educate us about our options with surgery.
I’m sure we’ve posted examples of patients that didn’t want a fully restored hairline on this site in the past, and I know there have been plenty of men who have had surgery for a “minimalistic” path. A patient must give us permission before publishing their pictures, so we’re only able to post those that have given their consent. Not every patient wants their photos shown to others.
There are comprehensive before / after pictures in our NHI photo galleries that will show various examples of hairline restoration.
I think most surgeons tend to restore to a Norwood 2 rather than a more juvenile Norwood 1 as its more age-appropriate to have a mature hairline. I know many men posting on here would prefer a juvenile/straight hairline Norwood 1 – but that seems less common outside of the over 35’s at least.
Paul, I thought there were lots of guys who are Norwood 1’s but with mature hair lines. I’m nowhere the expert Doc R is, but I don’t think a straight hairline means to have a juvenile hairline.
The doc has explained mature hairlines in various posts – I suppose it depends what you call a ‘straight’ hairline – since a mature hairline can have some degree of corner recession (but not as much as a Norwood 3). Dr Bernstein classes Norwood 1 as a juvenile hairline and Norwood 2 as a matured hairline (whilst noting that the Norwood scale doesn’t describe every individual hair pattern as its impossible to have a simple picture handle all individual variation).
I note dr rassman has said that in the past most doctors haven’t wanted to restore even a fully matured hairline, which he argued is something all men would aim for.
Juvenile hairlines are not all ‘straight across’ but typically a lot lower at the corners. I just see the Norwood 2 being called an approximation of a typical mature hairline. So I doubt many doctors go as far as a Norwood 1 except on men who are insistent on a younger looking hairline or who have no real balding.
What Dr. R said (I don’t remember in which entry) was that the leading edge of the hair line needs to be placed as far as in the mature position (and no further behind that) in order to look natural. I do not believe Dr. R has said the same for corners of the hairline.
But I thought ‘mature’ and ‘juvenile’ refer to a difference in height of the hairline, rather than to differences in shape.
The definition given by Dr Rassman in his mature hairline post is about 1/2 inch higher at the midpoint of the hairline and up to 1 1/2 inches at the corners – so this would cover the rather curved hairlines but not the Norwood 3 with more extreme corner/frontal erosion. In a recent post answer Dr Rassman suggested some mature hairlines could look close to a Norwood 3 without any true balding.
The mature hairline can certainly be a different shape to a juvenile hairline. It does seem to be something a doctor has to judge carefully though. If you look at some of the celebrities the doctor is asked to comment on he’s shown some men who move from a perfectly straight hairline when younger to a steep curved M shape but he’s suggested as there’s limited erosion and has remained strong this is a typical mature hairline.
If you read some posts about his surgery suggestions Dr Rassman has suggested he prefers not to recommend surgery for Norwood 1 or 2 hairlines and Norwood 3 is considered the first class with balding. Although obviously he’s done work on some men who have Norwood 2 hairlines to make them Norwood 1’s. I suppose its just down to what hairline suits your face shape/head shape/preference/budget/etc.